Uterine displacement device

ABSTRACT

This disclosure is directed to a mechanical device to effect left uterine displacement to prevent or treat supine hypotensive syndrome in a patient, e.g., during Cesarean Section operations. The device includes an adjustable stanchion adapted to be suitably supported adjacent a patient to which there is connected an adjustable arm and associated compression means for effecting left displacement of the uterus. The device is constructed for universal adjustment in any of the three axial planes so as to be readily adjusted to any particular patient.

United States Patent Colon-Morales [4 1 June 13, 1972 [54] UTERINEDISPLACEMENT DEVICE 835,678 11/1906 Hammond .,...248/124 1,154,8389/1915 Best ..248/286 [721 Invent zgfg' g m gg' 1,625,682 4/1927 Ragg..269/328 [22] Filed: Nov. 16, 1970 Primary Examiner-Dalton L. Truluckpp 89 688 An0rney-ArthurT.Fattibene ABSTRACT [52] U.S.CI..l28/36l,248/l24, 2246890238268, This disclosure is dire cte d toamechanic a1 device to effect left 51 I Cl A 61b 17/42 uterinedisplacement to prevent or treat supine hypotensive d A 20 syndrome in apatient, e.g., during Cesarean Section operae m 2 48 4 h tions. Thedevice includes an adjustable stanchion adapted to be suitably supportedadjacent a patient to which there is connected an adjustable arm andassociated compression means [56] Rem-mes Cited for effecting leftdisplacement of the uterus. The device is con- UNITED STATES PATENTSstructed for universal adjustment in any of the three axial planes so asto be readily adjusted to any particular patient. 3,389,702 6/1968Kennedy ..128/361 3,461,861 8/1969 Barkalow ..l28/ 145.8 X 4 Claims, 8Drawing Figures PATENTEDJUN 13 m2 3.669.118

' SHEET 1UP 3 I NVENTOR.

F/ea I if ATTORNEY MIGUEL ANGEL COLON-'MORALES PAIENTEBm 13 m2 SHEET 20F 3 INVENTOR. MIGUEL ANGEL COLON'MOPALES ATTORNEY PATENTEmuu 13 I9723.669. 1 18 sum a nr 3 INVENTOR.

MIGUEL ANGEL COLON-MORALESI f y x ATTORNEY PROBLEM AND PRIOR ART Itfrequently happens during delivery that when a pregnant patient is in asupine position, that the uterus and the weight of the unborn baby tendto compress the inferior vena cava thereby decreasing the uterine bloodflow in proportion to the decrease experienced in the maternal bloodpressure. The supine hypotensive syndrome is especially present duringCesarean sections as a result of muscle relaxant drugs administered tothe patient during the operation. To counteract the supine hypotensivesyndrome vasopressors have been administered to increase the patientsblood pressure.

However, the use of such vasopressors, either prophylactically ortherapeutically, during Cesarean sections under regional anesthesia mayinvite certain calculated risks. For example, the synergistic effect ofoxytoxic and vasopressors constitutes a potential danger with severeconsequences to the parturient.

It is know that the use of vasopressors may bring on in certain patientsundergoing Cesarean sections an uncontrollable hypertensive crisis thatcan result in a cerebrovascular accident.

It has been observed that the supine hypotensive syndrome noted inpatients during Cesarean sections could be relieved by effecting adisplacement of the uterus, thus relieving the pressure on the inferiorvena cava. This was heretofore effected by turning the patient over onher left side, or tilting the operating table approximately 30 to theleft, or by placing a sand bag under the patients right hip. Thesephysical methods of displacing the uterus provide impractical becauseinvariably they interfered with the operative procedures.

Another method which was employed was for the surgeon, his assistant orthe anesthesiologist to effect manual displacement of the uterus.However this method required the use of ones hand and attention whichdetracted the holder from his more important functions of attending tothe operating procedures.

OBJECTS It is an object of this invention to provide for a mechanicaldevice to effect a left uterine displacement during Cesarean Sections toprevent or treat supine hypotensive syndrome in a patient.

Another object is to provide a mechanical uterine displacement devicewhich when set does not require the attention of any operating roompersonnel.

Another object is to provide a mechanical uterine displacement devicewhich can be readily adjusted to any particular patient.

BRIEF SUMMARY OF THE INVENTION The foregoing objects and other featuresand advantages of this invention are attained by a left uterinedisplacement device which comprises a telescoping stanchion in whichtelescoping members may rotate and/or extend with respect to oneanother. The telescoping stanchion is formed to fit a fixture or fittingnormally found along the edge of an operating table, or to be detachablyconnected to a supporting plate which may be placed beneath the body ofa supine patient. Connected to the upper end of the stanchion is anadjustable head. The adjustable head includes a first head portion whichis fixedly secured to the stanchion and a second head portion mountedfor relative rotation with respect to the first head portion. A lockingmeans is operatively associated with the respective head portions tofixedly secure them in an adjusted position.

Connected to the relatively movable head portion is an extendable armwhich has connected to the end thereof a compression pad adapted toengage the body of the patient to effect uterine displacement, and meansare provided for locking the arm in the adjusted position thereof. Thearrangement of the left uterine displacement device is such that the armand 2 the associated compression pad may be readily adjusted in any ofthe three spatial planes.

Features which is positive in operation.

Another feature of this invention resides in the provision of a leftuterine displacement device in which the compressing pad may be readilyadjustable in each of the three spatial planes so that the device isrendered universally adaptable for any patient.

Another feature of this invention resides in the provision of a uterinedisplacement device which can be optionally connected to a fitting orattachment normally found along the edge of an operating table or to asupport which may be disposed below the body of a supine patient.

Another feature of this invention resides in the provision of a uterinedisplacement device having its own supporting base means adapted to beplaced beneath the body of a supine patient.

Other features and advantages will become more readily apparent whenconsidered in view of the drawings and speciflca tion in which:

FIG. 1 illustrates a perspective view of a left uterine device embodyingthe invention.

FIG. 2 illustrates a left uterine displacement device as applied to thebody of a patient.

FIG. 3 is an elevation view of the uterine displacement device havingportions thereof shown in section.

FIG. 4 is a detailed view of an adaptor by which the uterinedisplacement device may be secured to the attachment fixture of anoperating table.

FIG. 5 is a perspectiveview illustrating a modified adaptor.

FIG. 6 is a detail view of the adaptor of FIG. 5.

7 is a perspective view of a modified form of the invention.

FIG. 8 illustrates the embodiment of FIG. 7 applied to a body of apatient.

DETAILED DESCRIPTION Referring to the drawings there is shown in FIG. 1,a left uterine displacement device 10 embodying the present invention.The uterine displacement device 10 may be formed to be optionallyconnected to a fitting (not shown) generally found on an operating tableor to a support means 11 in the form of a flat plate 11A which isadaptedto be positionedunder the body B of a supine patient. It will beunderstood that the plate 11A may be formed of any desired material,e.g., metal, plastic or wood. In the illustrated form of the inventionthe support plate 11A is provided with a connector 12 adjacent an edgeportion by which the stanchion means 13 of the uterine displacementdevice may be detachably connected thereto. As shown the connector 12 isillustrated as comprising of an internally threaded boss fixedly securedto the plate 11A. However, the connector 12 may comprise any desiredtype of connector for detachably receiving the stanchion means 13.

The stanchion means 13 comprises telescoping members including an outermember 14, formed of a suitable tubular construction, having anexternally threaded lower end portion 13A by which it may be detachablythreaded to the connector 12 of the support plate. Slidably disposedwithin the bore 138 of the outer telescopic member 14 is an inner orslidable member 15 which is adapted to move between an extended andretracted position relative to the outer telescoping member 14. Theslidable member 15 receivable within the bore 138 of the outer member 14is also free to rotate within the bore 138 relative to the outer member14. A set screw or look screw l6is provided by which the inner membermay be comprises a first head portion 18 which is fixedly secured to theend of the slidable member 15. A tapped hole 18A extends laterally intothe first head portion 18. A second head portion 19 is rotatablyjournaled relative to the first head portion about a pin or screw 20which is threaded into the tapped hole 18A of head portion 18. The pinor screw 20 includes a shank portion that extends through an opening 19Ain head portion 19, the opening 19A having a diameter sightly greaterthan the diameter of the shank so that the head portion 19 may rotateabout the shank of pin 20, as will be hereinafter described. The pin orscrew 20 is provided with a shoulder 20A which is adapted to bearagainst head portion 19 when the screw 20 is threaded tightly into thetapped hole 18A. Thus the arrangement is such that the screw 20functions as a locking means for securing the head portions 18 and 19inan angularly adjusted position when the screw 20 is threaded tightlyinto tapped hole 18A. To facilitate the threading of the screw 20 intoand out of the tapped hole 18A an operating handle 21 is suitablyconnected to the head end portion of the locking screw 20.

Connected to the movable head portion 19 of the adjusting head means 17is an arm 22 which is arranged to laterally extend and retract relativeto the adjusting head 17. In the illustrated form of the invention thelateral adjustment of the arm 22 is effected by slidably supporting thearm 22 in a sleeve mounting 23 secured to the movable head portion 19.The sleeve is provided with a longitudinally extending bore 23A in whichthe arm 22 is free to slide. A set screw 24 threaded through the sleeve23 is provided to fix the arm 22 in the adjusted position thereof.

To the free end of the arm 22 there is connected compressive pad 25formed of a suitable resilient material, e.g., rubber, foraminousplastic, or the like. In the illustrated form of the invention thecompressing pad 25 is semi-spherical or bulbous in form. The compressivepad 25 carried on the end of the extensible arm 22 is such that it canbe adjusted to exert the desired compressive force on the body of thepatient which is effectively distributed over a sufficiently largesurface area of the abdomen to effect the necessary displacement of theuterus during Cesarean sections so as to relieve the pressure it wouldotherwise exert on the inferior vena cava blood vessel. With the leftuterine displacement device described, properly positioned against theabdomen of a patient, the uterus can be maintained in a properlydisplaced position throughout a Cesarean Section in a manner to eitheravoid or greatly minimize any supine hypotensive syndrome duringCesarean sections, without further attention by the operating roompersonnel.

If desired, the stanchion means 13 of the uterine displacement devicemay be made attachable to the fixtures which are normally provided alongthe edge portion of an operating table. This can be readily effected bythe utilization of an adaptor 27 which may be detachably connected tothe lower or threaded end portion 13A of the telescoping stanchion 13.As best seen in FIG. 4 the adaptor 27 may comprise a threaded holder 27Awhich is adapted to detachably receive the lower end 13A of thestanchion l3, and which holder is provided with a depending tongue 278which is adapted to be received in the conventional attachment fixture(not shown) normally found on an operating table. Thus the stanchion l3and associated adjusting head 17 with the expensible arm 22 of the leftuterine displacement device 10 described can be readily adapted tosecure either directly to an operating table with the use of the adaptorholder 27 or may be detachably secured to a support plate 11A which maybe adapted to be positioned beneath the body of a supine patient.

The left uterine device 10 described thus provides a mechanical meanswhereby the supine hypotesnive syndrome of a patient during Cesareansection may be avoided, thus obviating the need of utilizing vasopressordrugs during Cesarean sections and avoiding the dangers or risksheretofore incidental to the use of vasopressors. Also the left uterinedisplacement device described enables the attending physician and/oranesthesiologist to assume their normal position during Cesareansections permitting them to maintain the free use of both of their handsto perform the necessary operating func trons.

FIGS. 5 and 6 illustrate a modified adaptor. As seen in FIG. 5 anoperating table 60 is provided with a side rail 61 spaced along theopposed longitudinal edges of table 60. In accordance with thisinvention an adaptor, as illustrated in FIGS. 5 and 6 is providedwhereby the uterine displacement device may be detachably secured to theoperating table. As seen in FIGS. 5 and 6 the adaptor 62 comprises aholder portion 62A which is provided with internal threads 63 todetachably receive the lower threaded end portion 13A of stanchion 13.

Depending below the bottom of holder 62A are bifurcated or spaced aparttongue portions 64-64 which are adapted to straddle the side bar 61 asseen in FIG. 5. One of the tongue portions 64 is provided with a tappedhole 65 for receiving a set screw 66 by which the adaptor may be fixedlysecured in position along the side rail 61. Thus by loosening the setscrew 66, the adaptor may be either removed from the side rail 61 oradjusted longitudinally therealong. The adaptor 62 thus enables theuterine displacement device to be readily adapted for use in conjunctionwith an operating table in a manner whereby it can be readily adjustedlongitudinally along the table 60.

While a screw thread detachable coupling is illustrated between theadaptor 27 and 62 and the stanchion means 13 of the uterine device, itwill be understood that any readily detachable coupling means may beutilized in lieu of the threaded coupling described.

FIGS. 7 and 8 illustrate a modified uterine displacement device. Thisembodiment is similar to that described with respect to FIGS. 1 to 3with the exception that the inner member 40 of the stanchion means 41 isconnected to the base or support 42 with the outer stanchion member 43free to move relative to member 40. Set screw 43A adjustably secures therespective stanchion members 40, 43 in adjusted position. The outerstanchion member 43 is fixedly secured to head portion 44 of theadjusting head 45; and head portion 46 is rotatably adjusted about pin47 in a manner similar to that of FIGS. 1 and 2.

Adjustable head portion 46 is provided with a bore 46A for slidablyreceiving arm 48. The arrangement is such that the arm 48 is free tolaterally extend and distend relative to head portion 46. A set screw 49threaded in a tapped hole 51 intersecting with bore 46A secures the armin the adjusted position.

In this embodiment the adjustable arm is thus carried in a bore 46Aextending through a chordal portion of the rotatable head portion 46.Connected to the free end of arm 48 is a compression pad 50 by which acompressive force is exerted against a body B of a patient as shown inFIG. 8.

In operation, the embodiment of FIGS. 7 and 8 is similar to thatdescribed with respect to FIGS. 1 to 4. It will be of course understoodthat stanchion means 41 of FIG. 7 can be connected to base or support 42so as to be readily detachable to permit it to be detachably connectedto the fixture or attachments generally found on an operating table.

While the instant invention has been described with respect toparticular embodiments thereof it will be readily appreciated andunderstood that variations and modifications may be made withoutdeparting from the spirit or scope of the invention.

What is claimed is:

1. A uterine displacement device comprising:

a base support in the form of a flat plate adapted to extend under thebody of a supine patient,

a stanchion means extending upwardly from said flat plate adjacent oneend thereof,

said stanchion means including at least a pair of nested telescopingmembers,

one of said telescoping stanchion members being connected to said plateand the other being movably mounted with respect thereto to vary thevertical extended length of said stanchion means,

means for securing said telescoping stanchion members in the adjustedposition,

and an adjusting head means connected to the end of said movable memberof said stanchion means,

said adjusting head means including a fixed head portion connected tosaid movable member, said fixed head having a tapped hole therein,

and a movable head portion rotatably adjusted relative to said fixedhead portion, said movable head having a bore extending therethrough,each of said head portions having smooth complementary bearing surfaces,

means for securing said head portions in adjusted position,

and said means for securing said adjusting head portions includes a lockpin having a threaded shank adapted to be threaded into said tapped holeand a stop shoulder disposed intermediate the length of said pin,

said bore being slightly larger than the diameter of said threaded shankand smaller than the diameter of said shoulder whereby said headportions are maintained in adjusted position by said lock pin in thefully threaded position thereof,

an arm connected to said movable head portion,

said arm extending laterally outwardly of said adjusting head means,

means for adjusting said arm laterally of said adjusting head means,

means for securing said arm in the laterally adjusted position,

and a compression means connected to the free end of said arm.

2. A uterine displacement device as defined in claim 1 wherein said armadjusting means includes:

a sleeve connected to said movable head portion,

said sleeve having a bore therein for adjustably receiving said arm forlateral extension or retraction,

and said means of adjustably securing said arm including a manual setscrew having an angularly disposed handle portion.

3. A uterine displacement device comprising:

a support means,

a stanchion means extending upwardly from said support means,

said stanchion means including at least a pair of nested telescopingmembers,

one of said telescoping stanchion members being connected to saidsupport means, and the other being movably mounted with respect theretoto vary the adjusted vertical length of said stanchion means,

means for readily securing said telescoping stanchion members in theadjusted position,

an adjusting head means connected to the end of said movable stanchionmember,

said adjusting head means including a fixed head portion connected tosaid movable stanchion member,

said fixed head portion having a tapped hole therein,

a movable head portion rotatably adjusted relative to said fixed headportion,

said movable head portion having a bore extending therethrough, saidbore being disposed in axial alignment with said tapped hole ofsaidfixed head portion,

each of said head portions having smooth complementary bearing surfaces,

means for securing said head portions in adjusted angular relationshipwith respect to one another,

said means for securing said adjusting head portions including a lockpin having a threaded shank adapted to be threaded into said tapped holeand a stop shoulder disposed intermediate the length of said lock pin,

said bore of said movable head portion being slightly larger than thediameter of said threaded shank and smaller than the diameter of saidshoulder whereby said head portions are maintained in relative adjustedangular relationship by said lock pin in the fully threaded positionthereof,

an arm connected to said movable head portion, said arm extendinglaterally outwardly of said adjusting head means,

means for adjusting said arm laterally of said adjusting head means,

means for securing said arm in the laterally adjusted position,

and a compression means connected. to the free end of said arm.

4. A uterine displacement device as defined in claim 3 wherein saidsupport means comprises:

an adapter adapted to connect to a slide rail on an operating table,

and means for detachably connecting said stanchion means to saidadaptor,

and said adaptor including a depending bifurcated end portion adapted tostraddle said slide rail whereby said uterine displacement device can beslidably positioned along said slide rail,

one of said bifurcates having a tapped hole extending therethrough,

and a locking screw threaded to said tapped hole of said bifurcate forsecuring said adaptor to said slide rail in the adjusted positionthereof.

1. A uterine displacement device comprising: a base support in the formof a flat plate adapted to extend under the body of a supine patient, astanchion means extending upwardly from said flat plate adjacent one endthereof, said stanchion means including at least a pair of nestedtelescoping members, one of said telescoping stanchion members beingconnected to said plate and the other being movably mounted with respectthereto to vary the vertical extended length of said stanchion means,means for securing said telescoping stanchion members in the adjustedposition, and an adjusting head means connected to the end of saidmovable member of said stanchion means, said adjusting head meansincluding a fixed head portion connected to said movable member, saidfixed head having a tapped hole therein, and a movable head portionrotatably adjusted relative to said fixed head portion, said movablehead having a bore extending therethrough, each of said head portionshaving smooth complementary bearing surfaces, means for securing saidhead portions in adjusted position, and said means for securing saidadjusting head portions includes a lock pin having a threaded shankadapted to be threaded into said tapped hole and a stop shoulderdisposed intermediate the length of said pin, said bore being slightlylarger than the diameter of said threaded shank and smaller than thediameter of said shoulder whereby said head portions are maintained inadjusted position by said lock pin in the fully threaded positionthereof, an arm connected to said movable head portion, said armextending laterally outwardly of said adjusting head means, means foradjusting said arm laterally of said adjusting head means, means forsecuring said arm in the laterally adjusted position, and a compressionmeans connected to the free end of said arm.
 2. A uterine displacementdevice as defined in claim 1 wherein said arm adjusting means includes:a sleeve connected to said movable head portion, said sleeve having abore therein for adjustably receiving said arm for lateral extension orretraction, and said means of adjustably securing said arm including amanual set screw having an angularly disposed handle portion.
 3. Auterine displacement device comprising: a support means, a stanchionmeans extending upwardly from said support means, said stanchion meansincluding at least a pair of nested telescoping members, one of saidtelescoping stanchion members being connected to said support means, andthe other being movably mounted with respect thereto to vary theadjusted vertical length of said stanchion means, means for readilysecuring said telescoping stanchion members in the adjusted position, anadjusting head means connected to the end of said movable stanchionmember, said adjusting head means including a fixed head portionconnected to said movable stanchion member, said fixed head portionhaving a tapped hole therein, a movable head portion rotatably adjustedrelative to said fixed head portion, said movable head portion having abore extending therethrough, said bore being disposed in axial alignmentwith said tapped hole ofsaid fixed head portion, each of said headportions having smooth complementary bearing surfaces, means forsecuring said head portions in adjusted angular relationship withrespect to one another, said means for securIng said adjusting headportions including a lock pin having a threaded shank adapted to bethreaded into said tapped hole and a stop shoulder disposed intermediatethe length of said lock pin, said bore of said movable head portionbeing slightly larger than the diameter of said threaded shank andsmaller than the diameter of said shoulder whereby said head portionsare maintained in relative adjusted angular relationship by said lockpin in the fully threaded position thereof, an arm connected to saidmovable head portion, said arm extending laterally outwardly of saidadjusting head means, means for adjusting said arm laterally of saidadjusting head means, means for securing said arm in the laterallyadjusted position, and a compression means connected to the free end ofsaid arm.
 4. A uterine displacement device as defined in claim 3 whereinsaid support means comprises: an adapter adapted to connect to a sliderail on an operating table, and means for detachably connecting saidstanchion means to said adaptor, and said adaptor including a dependingbifurcated end portion adapted to straddle said slide rail whereby saiduterine displacement device can be slidably positioned along said sliderail, one of said bifurcates having a tapped hole extendingtherethrough, and a locking screw threaded to said tapped hole of saidbifurcate for securing said adaptor to said slide rail in the adjustedposition thereof.